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Risk factors for rejection of synthetic suburethral slings for stress urinary incontinence: a case-control study.

Persson, Jan LU ; Iosif, Constantin LU and Wölner-Hanssen, Pål LU (2002) In Obstetrics and Gynecology 99(4). p.629-634
Abstract
OBJECTIVE:To identify variables associated with rejection of synthetic, suburethral slings used for female stress urinary incontinence.METHODS:Between 1991 and 1998, gynecologists at our department performed 428 operations for stress urinary incontinence by inserting expanded polytetrafluoroethylene or polyethylene suburethral slings. After suitable exclusions, 386 women followed for at least 24 months after surgery remained for analysis. Of the 386 women, 47 (12.2%) had graft rejection or symptoms associated with rejection within 24 months after surgery, which led to later removal. We compared cases and controls using logistic regression analyses with forward selection to identify independent risk factors and risk markers for... (More)
OBJECTIVE:To identify variables associated with rejection of synthetic, suburethral slings used for female stress urinary incontinence.METHODS:Between 1991 and 1998, gynecologists at our department performed 428 operations for stress urinary incontinence by inserting expanded polytetrafluoroethylene or polyethylene suburethral slings. After suitable exclusions, 386 women followed for at least 24 months after surgery remained for analysis. Of the 386 women, 47 (12.2%) had graft rejection or symptoms associated with rejection within 24 months after surgery, which led to later removal. We compared cases and controls using logistic regression analyses with forward selection to identify independent risk factors and risk markers for rejection.RESULTS:The rejection rate declined sharply during the years 1993-1994 after introduction of routines that included preoperative prophylactic antibiotics active against anaerobes and repeated preoperative treatment of the vagina with chlorhexidine acetate. After adjusting for potentially confounding variables, surgery after 1993, the gynecologist performing the procedure, and adequate antibiotic prophylaxis remained significantly associated with a lower rejection rate. There was no significant association between rejection and sling material, age at surgery, year of surgery (in one year steps), or concomitant prolapse surgery.CONCLUSION:Rejection of suburethral slings might be associated with bacterial contamination of the graft, and the rate was decreased with prophylactic antibiotics a repeated and vaginal disinfection. (Less)
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published
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in
Obstetrics and Gynecology
volume
99
issue
4
pages
629 - 634
publisher
Lippincott Williams & Wilkins
external identifiers
  • pmid:12039125
  • wos:000174635200023
  • scopus:0036128886
ISSN
1873-233X
language
English
LU publication?
yes
id
0c4a8bf3-ef68-4297-b7d9-1683338e8e6a (old id 108609)
alternative location
http://www.ncbi.nlm.nih.gov:80/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12039125&dopt=Abstract
date added to LUP
2007-07-18 11:06:19
date last changed
2017-01-01 07:03:35
@article{0c4a8bf3-ef68-4297-b7d9-1683338e8e6a,
  abstract     = {OBJECTIVE:To identify variables associated with rejection of synthetic, suburethral slings used for female stress urinary incontinence.METHODS:Between 1991 and 1998, gynecologists at our department performed 428 operations for stress urinary incontinence by inserting expanded polytetrafluoroethylene or polyethylene suburethral slings. After suitable exclusions, 386 women followed for at least 24 months after surgery remained for analysis. Of the 386 women, 47 (12.2%) had graft rejection or symptoms associated with rejection within 24 months after surgery, which led to later removal. We compared cases and controls using logistic regression analyses with forward selection to identify independent risk factors and risk markers for rejection.RESULTS:The rejection rate declined sharply during the years 1993-1994 after introduction of routines that included preoperative prophylactic antibiotics active against anaerobes and repeated preoperative treatment of the vagina with chlorhexidine acetate. After adjusting for potentially confounding variables, surgery after 1993, the gynecologist performing the procedure, and adequate antibiotic prophylaxis remained significantly associated with a lower rejection rate. There was no significant association between rejection and sling material, age at surgery, year of surgery (in one year steps), or concomitant prolapse surgery.CONCLUSION:Rejection of suburethral slings might be associated with bacterial contamination of the graft, and the rate was decreased with prophylactic antibiotics a repeated and vaginal disinfection.},
  author       = {Persson, Jan and Iosif, Constantin and Wölner-Hanssen, Pål},
  issn         = {1873-233X},
  language     = {eng},
  number       = {4},
  pages        = {629--634},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Obstetrics and Gynecology},
  title        = {Risk factors for rejection of synthetic suburethral slings for stress urinary incontinence: a case-control study.},
  volume       = {99},
  year         = {2002},
}